Provider Demographics
NPI:1972590016
Name:KLOPFSTEIN, JENNIFER NELL (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:NELL
Last Name:KLOPFSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9252 N GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53209-1104
Mailing Address - Country:US
Mailing Address - Phone:414-527-5089
Mailing Address - Fax:414-365-6349
Practice Address - Street 1:9252 N GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53209-1104
Practice Address - Country:US
Practice Address - Phone:414-527-5089
Practice Address - Fax:414-365-6349
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI30999-020208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI041868480OtherMEDICARE PTAN
WI046073840OtherMEDICARE PTAN
WIE56828Medicare UPIN